A client who has been hospitalized with disorganized type schizophrenia for 8 years can’t complete activities of daily living (ADLs) without staff direction and assistance. The nurse formulates a nursing diagnosis of Self-care deficit: Dressing/grooming related to inability to function without assistance. What is an appropriate goal for this client?

Correct Answer: C. “Client will be able to complete ADLs with assistance in organizing grooming items and clothing within 1 month.”

The client’s disorganized personality and history of hospitalization have affected the ability to perform self-care activities. Disorganized schizophrenia is one of the five subtypes of schizophrenia. It is characterized by disorganized behavior and speech and includes disturbance in emotional expression. Hallucinations and delusions are less pronounced with disorganized schizophrenia, though there is evidence of these symptoms occurring.

• Option A: Interventions should be directed at helping the client complete ADLs with the assistance of staff members, who can provide needed structure by helping the client select grooming items and clothing. This goal promotes realistic independence. Assistance with life skills can help individuals with disorganized schizophrenia improve social interactions and increase daily living skills, with a goal of increasing independence.
• Option B: As the client improves and achieves the established goal, the nurse can set new goals that focus on the client completing ADLs with only verbal encouragement and, ultimately, completing them independently. Individuals with disorganized schizophrenia benefit from ongoing contact with the family. Support to educate the family about treatment and how to support a family member with schizophrenia is crucial. Family support increases family member’s understanding of the disorder and helps family members develop coping strategies.
• Option D: The client’s condition doesn’t indicate a need for complete assistance, which would only foster dependence. Assistance with daily living skills, educational attainment, employment services, and family support plays a key role in improving the course of the disease for individuals diagnosed with disorganized schizophrenia.